11/15/2000
ON MONDAY, in conjunction with the annual conference of the American Public
Health Association taking place in Boston this week, a few people gathered at
the Midtown Hotel for a press conference announcing a campaign that targets a
rarely noticed disparity in health care: a gender gap in which men are on the
losing side.

It's a
well-known fact that women, on average, outlive men by six years. Between 15 and
44, men's mortality rates are more than twice as high as women's. These
shortfalls are noted in ''Healthy People 2010,'' a report issued this year by
the Surgeon General and the US Department of Health and Human Services outlining
a health care agenda. But Edward Bartlett, a professor of public health at
George Washington University and president of a group called Men's Health
America, points out that no action has been taken to address such concerns.
There are no men's health committees or task forces; the HHS has an Office of
Women's Health but no Office of Men's Health.

The reason
for this neglect, Bartlett said at the press conference, is the belief that
gender equity requires more attention to women's health concerns. A decade ago,
claims that women had been shortchanged by a male-dominated medical
establishment caused an outcry from activists and legislators. As it happens,
these allegations were little more than a politically driven myth.

In 1990,
the Congressional Women's Caucus raised a ruckus over a government report
showing that less than 14 percent of the money spent by the National Institutes
of Health in 1987 went to female-specific illnesses. Yet less than 7 percent of
the NIH budget was allocated to male-specific problems; the rest was spent on
studying diseases that afflict both sexes.

But weren't
those diseases studied almost exclusively in men? No. In 1979, the earliest year
for which such data are available, 268 of the 293 NIH-funded clinical trials
included both male and female subjects - and of the remaining 25 studies, 13
were all-female.An analysis of medical literature in the Medline database shows
a similar picture. Over two-thirds of clinical trials in the 1970s and 80s
included both sexes, while single-sex trials were almost evenly divided between
all-male and all-female ones.

Women's
''exclusion'' from heart disease research has drawn especially harsh criticism.
In fact, nearly a third of clinical trials of heart disease treatment and
prevention in 1996-1991 were all-male. This was primarily because it often makes
scientific sense to study a disease first in the population in which it occurs
most often - and men under 65 are three times more likely to have heart attacks
than women.

Remarkably,
however, during the same period men were underrepresented as subjects in
cancer-related trials (even though they suffer from cancer at higher rates than
women). Perhaps the biggest myth is that breast cancer research was put on the
back burner due to sexism. Former congresswoman Patricia Schroeder of Colorado
once commented that male researchers are ''more worried about prostate cancer
than breast cancer.''

Yet from
1981 to 1991, the National Cancer Institute spent $658 million on breast cancer
research and $113 million on prostate cancer. Long before the rise of breast
cancer activism, medical journals published more reports on breast cancer than
on any other type of cancer.

Thanks to
the crusade to remedy perceived inequities, it seems that men's health is being
short-shrifted. A May 2000 report by the US General Accounting Office shows that
men now account for 37 percent of subjects enrolled in NIH research (down from
45 percent in 1994) and just 29 percent in cancer research. In recent years,
both Republicans and Democrats have been sponsoring women s health measures such
as minimum hospital stays for breast cancer surgery, while men are roundly
ignored.

The myth of
women's medical neglect has bred needless resentment in many women. It has also
hampered efforts to improve health care for men, who are much less likely to get
regular medical check-ups or to seek care promptly when they have symptoms of
illness, and more likely to be uninsured. At Monday's press conference, Irvienne
Goldson, a manager with the Men's Preventive Health Program in Boston, noted
that fears of shortchanging women make it difficult for men's health programs to
get funding.

But women
and men are not isolated from each other. When men die prematurely, the women
who love them are affected as well. Isn't it time to stop playing gender
politics with medicine and redirect our energy toward providing better care for
everyone?

Cathy Young
is a contributing editor at Reason magazine. Her column appears regularly in the
Globe.